Orem’s Philosophy

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Orem’s Philosophy

Orem's Philosophy

The main ideas of Orem’s philosophy include the idea that nursing is an art in which the nurse delivers specialized help to people with impairments, necessitating more than simple assistance to meet self-care demands. Additionally, the nurse actively contributes to the doctor’s treatment of the patient. Men, women, and children are humans and are the objects of direct caregivers’ material concern, whether they are being taken care of individually or in groups. Physical, chemical, and biological characteristics define the environment, which includes family, culture, and community. Being physically and functionally sound or whole is a sign of health. Human health is defined as the capacity to reflect on oneself, symbolize experience, and interact with others. It is a state that includes both the health of people and groups. Self-care is the practice of engaging in or initiating actions for oneself in order to preserve one’s own life, health, and well-being. The capacity or capability of a person to take care of themselves is known as self-care agency and is influenced by fundamental conditioning variables.

Clinical practice establishes inquiries for research and theoretical understanding. Nursing theories’ fundamental contribution to the clinical environment has also been the fostering of analyzing, questioning, and conceiving regarding what nursing is all about. Because nurses and nursing practice are frequently subservient to great organizational demands and norms, any framework that enables nurses to ruminate on, dispute, and deliberate regarding what they do is vital.

References

Tanaka M. Orem’s nursing self-care deficit theory: A theoretical analysis focusing on its philosophical and sociological foundation. Nurs Forum. 2022 May;57(3):480-485. doi: 10.1111/nuf.12696.https://pubmed.ncbi.nlm.nih.gov/35037258/ Epub 2022 Jan 17.

 
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Teamwork in Healthcare

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Teamwork in Healthcare

Scholarly Activities

Overview

Teamwork in Healthcare

Teamwork is an approach healthcare providers adopt to enhance cooperation in healthcare. It is currently recognized as a practice competency providers should develop and a measure to elevate quality in healthcare. Research shows that medical care accomplished through interdisciplinary cooperation is linked to high-quality care, increased patient safety, lower rehospitalization rates, and reduced medical errors and associated consequences, such as readmissions and complications (Rawlinson et al., 2021). Care coordination and patient access to healthcare services rely on effective interdisciplinary collaboration (Samuriwo, 2022). I participated in an interdisciplinary committee meeting to enhance collaboration and communication between nurses, physicians, physician assistants, and pharmacists to prevent medication error rates at the hospital. The meeting was held on 12th April 2023, and in attendance were APNs and APPs, including CNMs, CRNAs, NPs, physicians, physician assistants, and pharmacists. Members of the Board of Registered Nursing and the Medical Executive Committee were also present.

Problem

Despite the deployment of electronic health records (EHRs), clinical decision support systems (CDSSs), and computerized provider order entry (CPOE) at the hospital, medication errors are still a problem because human input is still critical to the accuracy of these systems. The success of these systems depends on cooperation between healthcare providers in direct contact with the patient (Manias, 2018). The meeting intended to devise ways to improve interdisciplinary collaboration and care coordination to minimize miscommunication, misunderstanding, and human errors identified as contributing significantly to medication errors that expose patients to adverse drug events and reactions and put the hospital at risk of increased legal cases.

Intervention

The meeting was successful, and members agreed on potential strategies for improving interdisciplinary collaboration. These strategies will be integrated into policy, standardized procedures, and standards of care. The effectiveness of these strategies will be reviewed monthly, and the committee will decide on a way forward per the review’s outcomes. To enhance interdisciplinary collaboration, members agreed to:

  • Improve communication practices and increasing communication channels to suit everyone’s preferred communication approach
  • Encourage giving and receiving feedback
  • Establish a platform for social interaction
  • Integrate collaboration into daily tasks and all projects at the hospital
  • Promote open communication among providers
  • Encourage sharing knowledge, insights, and resources
  • Cultivate a culture of mutual respect and trust among all team members

The committee agreed on a training program that will take two months to help providers develop these competencies and understand how to implement them in their daily practice. It will be on-practice training, and a self-evaluation test will be conducted at the end of the training to determine whether providers achieved their respective objectives.

The meeting was an opportunity to learn about the importance of interdisciplinary collaboration in healthcare delivery, barriers to effective interdisciplinary collaboration, and approaches that can help enhance collaboration and care coordination. I learned that every team member is responsible for ensuring compliance with agreed-upon solutions and adopting them to promote quality of care and patient safety. This meeting serves as appropriate monitoring of competency and ongoing professional practice evaluation to identify issues affecting the quality of service and devise ways to address them. I plan to engage in such meetings in the future and be an active leader in enhancing the quality of care and patient safety. Program competencies addressed in this meeting include promoting interprofessional collaborative communication with healthcare teams to ensure care quality and safety, participating in policy development and adoption, and engaging in critical thinking, ethical reasoning, and decision-making.

 

References

Manias E. (2018). Effects of interdisciplinary collaboration in hospitals on medication errors: an integrative review. Expert opinion on drug safety, 17(3), 259–275. https://doi.org/10.1080/14740338.2018.1424830

Rawlinson, C., Carron, T., Cohidon, C., Arditi, C., Hong, Q. N., Pluye, P., Peytremann-Bridevaux, I., & Gilles, I. (2021). An Overview of Reviews on Interprofessional Collaboration in Primary Care: Barriers and Facilitators. International journal of integrated care, 21(2), 32. https://doi.org/10.5334/ijic.5589

Samuriwo R. (2022). Interprofessional Collaboration-Time for a New Theory of Action?. Frontiers in medicine, 9, 876715. https://doi.org/10.3389/fmed.2022.876715

 
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Health Care for All

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Health Care for All

 Health Care for All Discussion Board Post

Pros and Cons of Medicare for All (MFA)

In Medicare for All (MFA), everyone in the country would be enrolled in a federally funded program rather than obtaining health insurance from an insurance provider, frequently through their place of employment. Progressives now endorse it, and Sen. Bernie Sanders (D-Vermont) vigorously supported it during his bids for the Democratic presidential nomination in 2016 and 2020.4 The benefits and cons of this program are somewhat influenced by an individual’s financial level. Sanders’ new tax will not apply to anybody who earns less than $250,000 but would apply to anybody who earns more than $250,000 annually or who is in the wealthiest 0.1% of households.4 Additionally, since the government regulates and negotiates the cost of medicines and medical services, universal healthcare reduces healthcare costs for the economy as a whole. Furthermore, it would do away with the administrative fees associated with dealing with various private health insurers.4 Doctors would have to engage with one government entity instead of various private insurance companies, Medicare and Medicaid.

Health Care for All

On the downside, some analysts worry that the government might not be positioned to use its negotiating position to lower costs as quickly and drastically as Sanders anticipates. Sanders, according to Thorpe, is being excessively optimistic about this proposal.4 Additionally, if people have no financial incentive to take care of their health, they might not do so as diligently.4 To control costs, governments must also restrict healthcare spending. Doctors who are not paid well can be less motivated to offer high-quality care.4 To reduce costs, physicians might treat patients for shorter periods of time. Providers also receive less money for innovative technology that saves lives.

Whether the MFA is an effective and efficient solution to the healthcare problem in America

There have been a variety of remarks on the growth of MFA. It results from decades of research, instruction, and campaigning, and its supporters see it as a reason for hope. America urgently needs an open discussion about health policy given the painful cost increases, service denials by insurance companies, and the almost 30 million uninsured citizens.2 In conclusion, it is a viable and practical solution to the issue of rising out-of-pocket expenses and a sizable uninsured population.2 However, to address its shortcomings, such as guaranteeing that doctors’ incentives are stable, it must be carefully planned and implemented.

Whether the current Medicare program can be extended to “All” in the current form

The current Medicare program works with eligible people. Although it is possible to extend the current Medicare program to “All,” it presents multiple design challenges that might be as costly as developing a separate program for “All” or “Medicare for All” from scratch. It would require eliminating current eligibility variations, enrollment, renewal processes, benefits, and payment and delivery systems of the existing Medicare structure.5 Additionally, services and opportunities available only to the vulnerable population would open for all.

Whether the healthcare system will accept what MFA will reimburse

The medical community is still divided on Medicare for All, with most doctors fearing a possible pay reduction. However, the Congressional Budget Office (CBO) anticipates that Medicare for All will boost healthcare utilization across society, leading to an increase in total provider income even if fee levels drop.3 In particular, the CBO estimates that, in 2030, total outpatient provider revenues, of which physician services currently make up 78%, would be 5 to 9% higher under Medicare for All than they would be today.3 If the MFA reimburses more than the present reimbursements, the healthcare system might accept it.

How the MFA Will Impact Private Insurance

The notion of doing away with private health insurance is at the core of the “Medicare for all” ideas supported by Senator Bernie Sanders and many Democrats.1 The whole healthcare system, which accounts for a fifth of the US economy, would be shaken by such a shift as hospitals, physicians’ offices, nursing homes, and pharmaceutical firms would all need to adjust to a new set of regulations.1 The federal government would be the new insurer for most Americans, and many would discover the value of the health insurance equities in their retirement accounts to be significantly reduced.

In conclusion, the MFA idea is designed for the good of all. It would help solve the problem of increasing healthcare costs and the high number of uninsured individuals. It is an appropriate plan for the US and would be the best if potential shortcomings are addressed. It is necessary that healthcare providers and physicians feel safe under the MFA by assuring their income will not reduce.

 

References

Abelson R, Sanger-Katz M. Medicare for All Would Abolish Private Insurance. ‘There’s No Precedent in American History.’ New York Times. 2019. https://www.nytimes.com/2019/03/23/health/private-health-insurance-medicare-for-all-bernie-sanders.html

Berwick D M. Stop fearmongering about ‘Medicare for All.’ Most families would pay less for better care. USA Today. Oct. 2019. https://www.usatoday.com/story/opinion/2019/10/22/medicare-all-simplicity-savings-better-health-care-column/4055597002/

Cai C. How Would Medicare for All Affect Physician Revenue?. Journal of General Internal Medicine. 2022 Feb;37(3):671-2.

Fisher S. Medicare for All: Definition, Pros and Cons. 2023. https://smartasset.com/insurance/medicare-for-all-definition-and-pros-and-cons

Tolbert J, Rudowitz R, Musumeci M. How Will Medicare-for-all Proposals Affect Medicaid? Kaiser Family Foundation, Sept. 2019 Sep 12;12.

 
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Business Paper: Reflection Question

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Business Paper: Reflection Question

 Professional Development Framework

Business Paper: Reflection Question

Potential for Growth in Advocate for Change Domain

As the competition for attention grows in recent years, it is increasingly difficult to get voices heard. The business environment is challenging, and organizations seek change agents to translate organizational priorities into reality and ensure continuous improvement. Advocacy for change in an organization is currently a professional growth opportunity. Helping the organization meet otherwise unmet needs, correct or reverse situations or errors, prevent loss in a business, and change public or consumer opinions are qualities and abilities any employer would admire and might open doors for an individual to get a promotion to a leadership position (The University of Kansas, n.d.). It is because of this reason leaders must be change agents in an organization. Examples of how I can be an advocate for change in real life include conducting advocacy research by gathering customer opinions of a product to understand their needs and improve on the product, providing education and encouraging by training fellow employees and consumers, engaging in direct action campaigns by lobbying decision makers on policies that impact the business, and using media advocacy to drive environmental sustainability initiatives of the organization.

Subdomain to be Developed

Over time, I have developed effective collaboration and communication skills, which are imperative in change advocacy. However, I need to develop mentoring/teaching and impacting policy subdomains. Organizations seek individuals who can transfer their knowledge to others, and this is possible through mentoring and teaching (Capella University, n.d.). Impacting policy can be enabled through lobbying policymakers to influence policy decisions that impact the business. I want to mentor and teach others as a form of developing and transferring knowledge to others in the future. I also intend to familiarize myself with policymakers and write to them regarding various policies to impact policy development and decision-making to benefit the business environment.

Goals for Professional Development in Advocate for Change Domain

My primary aim is to facilitate change and development through teaching and mentoring and influencing the development of new areas of policy to tackle unmet business needs and deal with emerging business needs in society. Regarding teaching, I want to understand the principles of teaching and learning, how to use effective instructional strategies, advising, and mentoring. Regarding impacting policy, I need to learn and understand the skills needed to influence and impact policy and principles of lobbying. I intend to make a difference in my future career space, and working on this goal will move me closer to this aspiration.

(Business Paper: Reflection Question)

Plan for Achieving Goals

To be successful in teaching and mentoring, I need to learn how to be one. I can enrol in an education program on how to become an educator to build basic competency of teaching and mentoring as part of continuing education for educators, participate in seminars and workshops geared toward knowledge transfer models and strategies, and engage in employee training. To impact policy within the organization and outside successfully, I need to learn how to be a good lobbyist, including how to engage legislators or leadership in the organization. I need to develop lobbyists qualities that lead to success, including being honest, observant, a good listener, responsive, a strong negotiator, highly persuasive, and an excellent communicator.

Employer Expectations of DBA in Initiating, Sponsoring, and Implementing Change

An employer expects that DBA degree holders can develop and transfer knowledge to others, including fellow employees and customers, help others improve performance by addressing their performance problems, adopt problem-solving strategies, and provide workable solutions (Capella University, n.d.). These expectations align with the developed goals because to help others improve performance, one must be a teacher or mentor to transfer the knowledge needed for performance improvement. Likewise, developing skills needed to impact policy is crucial because impacting policy is a problem-solving approach and can provide effective solutions to business problems through new policy development or current policy improvement.

Use of Professional Development in Interactions with Informal Contact Network

Informal contact networks are needed in daily life, including in the professional environment, and it is one of the ways advocates for change share or introduce their ideas or develop relationships with others necessary to enable and drive change. (Vătămănescu et al., 2022). Change advocacy resides within the professional development framework, but it interacts with the informal contact network because change advocates must engage people, and it can happen in informal spaces such as attending company parties, grabbing coffee with colleagues or policymakers, going for lunch with contacts, and meeting a group of coworkers during breaks or after work.

(Business Paper: Reflection Question)

Progress Toward Goals and Impacts Experienced

To teach and mentor others, I have engaged multiple teams in understanding business needs and employee needs and how these needs interact or conflict. The insights developed from this search are used to develop knowledge development areas and transfer the needed knowledge to ensure business and employee needs are not conflicting to ensure growth. I also share literature on various business concepts through various channels like social media, especially work WhatsApp groups. So far, I see improvement in the employees’ commitment to the organization’s goals and the organization’s commitment to fulfilling employees’ needs. I am still progressing toward impacting policy outside the organization, but within, I often engage leaders on how to improve policies that appear as barriers. Some policies were developed a long time ago, and their effectiveness in the current business environment is minimal, or they have undone themselves, according to Jacobs & Weaver (2015). Therefore, policy changes through leadership engagement are needed to remain competitive. After achieving these goals, I aim at engaging legislators in policy decision-making outside the organization. This a complex process, but I am working towards being an effective lobbyist and good negotiator to impact policy that promote business development and success.

References

Capella University. (n.d.). Professional Development Framework Guide. Capella University https://www.capellauniversity.edu/professional-development-framework-guide.pdf

Jacobs, A. M., & Weaver, R. K. (2015). When policies undo themselves: Self‐undermining feedback as a source of policy change. Governance, 28(4), 441-457.

The University of Kansas. (n.d.). 10. Advocating for Change. Community Tool Box. https://ctb.ku.edu/en/advocating-change

Vătămănescu, E. M., Mitan, A., Cotîrleț, P. C., & Andrei, A. G. (2022). Exploring the mediating role of knowledge sharing between informal business networks and organizational performance: An insight into SMEs internationalization in CEE. Sustainability, 14(7), 3915

 
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Pharmacotherapy for Insomnia in a 31-year-old Male Patient

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Pharmacotherapy for Insomnia in a 31-year-old Male Patient

Pharmacotherapy for Insomnia in a 31-year-old Male Patient

Pharmacotherapy for Insomnia in a 31-year-old Male Patient

Case Description

This case involves a 31-year-old patient presenting at the office complaining of sleep difficulties. The patient reports a worsening case of insomnia over the past six months. The patient has not had great sleep most of his life, but currently, the problem is severe because he struggles to fall asleep and stay asleep. It began 6 months ago after he lost his fiancé. The reports that the lack of sleep is impacting his capacity and ability to function properly, including working as a forklift operator at a local chemical company. The patient reports using diphenhydramine in the past to help him sleep but dislikes the side effects it causes in the morning after taking the drug. Due to lack of sleep from the night before, he has fallen asleep on the job. Per the previous physician assessment, the patient abused opiates before, which started when his ankle broke while skiing and followed a hydrocodone/apap (acetaminophen) prescription to manage the acute pain. The patient has not been prescribed opiate analgesic in 4 years, and he reports consuming alcohol recently to help him fall asleep, averaging four bears before going to bed.

Per the mental status assessment, the patient is alert and oriented to person, place, time, and event and maintains good eye contact and is dressed appropriately for the occasion and time of the year. The patient denies any auditory or visual hallucinations and has intact judgement, insight, and reality contact. The patient also denies any suicidal or homicidal thoughts or plans and is future-oriented.

Decision #1

Trazodone is the first option for treating insomnia in the patient. Trazodone is classified as a selective reuptake inhibitor with a low side effect profile. Trazodone is an effective medication to help the patient maintain sleep and low the frequency of early awakening. Research shows that trazodone can significantly improve perceived sleep quality and has good tolerance for insomnia short—term treatment (Yi et al., 2019). In a study involving 429 patients, patients prescribed trazodone perceived better sleep quality than individuals prescribed placebo (SMD = -0.41, 95% CI -0.82 to -0.00, P = 0.05) with an insignificantly moderate heterogeneity (Yi et al., 2019). Trazodone was also associated with a significant reduction in secondary efficacy outcomes compared to placebo.

It would not be appropriate to prescribe either sonata or hydroxyzine because trazodone presents better effectiveness and efficacy than the two. Also, sonata can cause the patient to experience complex sleep behaviors. Additionally, sonata is associated with adverse effects, including drowsiness, dizziness, diarrhea, grogginess, and impaired concentration (Bhandari & Sapra, 2019). Hydroxyzine has strong sedative properties, but most patients do not like the anticholinergic adverse effects the next morning, including xerostomia and xerophthalmia. Commonly, hydroxyzine leads to impaired motor function, blurred vision, dry mouth and throat, dizziness, confusion, abdominal stress, constipation and headache (Burgazli et al., 2023). It also leads to urinary retention complications and glaucoma.

Trazodone is an FDA-approved treatment for depression. Although it is not FDA-approved for aiding sleep, it is a common prescription with proven effectiveness and efficacy in improving sleep quality (Yi et al., 2019). This decision was selected as a short-term treatment for the patient’s insomnia. the effects would be assessed after some time before adopting a longer-term treatment or alternative therapy. Trazodone would be administered in low doses to promote safety and effectiveness in insomnia treatment. Generally, the decision to prescribe trazodone follows research evidence of its ability to improve sleep latency, duration, and quality, including helping the patient achieve deep sleep or slow-wave sleep.

Psychopharmacology often raises ethical issues attached to the respect of persons concerning a patient’s worth and dignity, information disclosure regarding the true risks and benefits of the drug, autonomy or self-governance, and beneficence. These ethical issues must be considered when developing the treatment plan and engaging the patient regarding their health problem.

Decision #2

Zolpidem has proved to enhance sleep latency and sleep duration measures and lower the frequency of awakenings in individuals with transient insomnia. It is effective in improving sleep quality in persons with chronic insomnia and can serve as a minor muscle relaxant (Edinoff et al., 2021). Despite the complex behavior associated with the medication, including hallucinations, increased risks of falls, accidents due to sleep driving, and increased suicidality and homicide ideation and plan, Zolpidem is a suitable treatment for insomnia.

Trazodone and eszopiclone are the other options that were not selected in the second decision because trazodone is suitable for short-term treatment, and eszopiclone presents a multitude of negative side effects, and it is recommended to avoid selecting it as either the initial or the second medication option due the complex side effects (Rösner et al., 2019). If mixed with alcohol or medications without the provider’s instruction, eszopiclone can cause euphoria until the patient is unconscious. It is also associated with an unpleasant taste, dry mouth, tiredness, and dizziness.

(Pharmacotherapy for Insomnia in a 31-year-old Male Patient)

Zolpidem is an FDA-approved short-term insomnia treatment. The primary aim of selecting the drug is to help the patient fall asleep because it has been proven to improve sleep latency, duration, and quality. The drug would also help the patient rapidly and effectively restore brain function (Edinoff et al., 2021). Ethically, the provider has to consider beneficence due to the complex adverse effects associated with Zolpidem, such as suicidality and homicidal ideation or sleep-driving, which threaten the patient’s safety. The provider should also disclose to the patient the risks and benefits of Zolpidem to guide decision-making.

Decision #3

Hydroxyzine can be used to treat insomnia with proven effectiveness and efficiency despite unpleasant side effects, including xerostomia and xerophthalmia. The drug has strong sedative properties, and research suggests it can be adopted as a short-term treatment for adults with sleeping difficulties (Burgazli et al., 2023). In a study, patients prescribed hydroxyzine reported improved sleep and fewer nightmares or hallucinations compared to controls (Burgazli et al., 2023). The drug is also well-tolerated despite the side effects like sleepiness and headache.

Trazodone and diphenhydramine were the other options in decision three but were not selected because of the associated side effects. Although trazodone is much safer and more effective, it can lead to headaches, sleepiness, and orthostatic hypotension. Diphenhydramine can be used together with hydroxyzine, but it can lead to impaired coordination, epigastric discomfort, dry mucous membranes, paradoxical, dizziness and drowsiness. Therefore, hydroxyzine was a better third-choice medication.

Hydroxyzine has a sedative effect that can help the patient start sleeping. It is not a typical prescription for people with insomnia but is more effective for primary insomnia not associated with any underlying cause (Burgazli et al., 2023). It was selected as a short-term treatment for insomnia in the patient as it has proven its ability to help the patient fall asleep. Ethically, the provider must assess whether the drug completely resolves the predisposition for insomnia. The provider must also maintain the confidentiality and privacy of the patient. The provider must communicate safety issues, including mixing hydroxyzine with alcohol or other CNS depressants.

Conclusion

Trazodone is the patient’s initial treatment option for insomnia. Trazodone is a powerful medicine that can help patients stay asleep and experience fewer frequent early awakenings. According to research, trazodone has an excellent tolerance for short-term treatment of insomnia and can greatly improve the quality of sleep as assessed by those taking it (Yi et al., 2019). To ensure safety and efficacy in treating insomnia, trazodone would be given in small dosages. The choice to prescribe trazodone typically results from research showing that it can increase sleep latency, duration, and quality, including assisting the patient in achieving deep or slow-wave sleep.

(Pharmacotherapy for Insomnia in a 31-year-old Male Patient)

Zolpidem is recommended as a substitute since it has been shown to improve sleep latency and sleep length measurements and reduce the frequency of awakenings in people with temporary insomnia (Edinoff et al., 2021). It can be used as a mild muscle relaxant and is beneficial in helping those with persistent insomnia get better quality sleep. Zolpidem is an effective treatment for insomnia despite the drug’s exacerbated side effects, including hallucinations, increased fall risks, accidents caused by sleep driving, and increased suicidal and homicidal thinking and planning (Edinoff et al., 2021). The third suggestion is Hydroxyzine, which has been shown to effectively treat insomnia despite having unfavorable side effects like xerostomia and xerophthalmia. The medication has potent sedative effects, and studies indicate that it may be used as an interim treatment for individuals who have trouble falling asleep (Burgazli et al., 2023). Patients who were given hydroxyzine in the research reported better sleep and fewer nightmares or hallucinations than the controls (Burgazli et al., 2023). Despite the side effects, including tiredness and headaches, the medication is also well tolerated.

References

Bhandari, P., & Sapra, A. (2019). Zaleplon. In: StatPearls [Internet]. Treasure Island (FL):

Burgazli, C. R., Rana, K. B., Brown, J. N., & Tillman, F., 3rd (2023). Efficacy and safety of hydroxyzine for sleep in adults: Systematic review. Human psychopharmacology, 38(2), e2864. https://doi.org/10.1002/hup.2864

Edinoff, A. N., Wu, N., Ghaffar, Y. T., Prejean, R., Gremillion, R., Cogburn, M., Chami, A. A., Kaye, A. M., & Kaye, A. D. (2021). Zolpidem: Efficacy and Side Effects for Insomnia. Health psychology research, 9(1), 24927. https://doi.org/10.52965/001c.24927

Rösner, S., Englbrecht, C., Wehrle, R., Hajak, G., & Soyka, M. (2019). Eszopiclone for insomnia. The Cochrane database of systematic reviews, 10(10), CD010703. https://doi.org/10.1002/14651858.CD010703.pub2

Yi, X. Y., Ni, S. F., Ghadami, M. R., Meng, H. Q., Chen, M. Y., Kuang, L., Zhang, Y. Q., Zhang, L., & Zhou, X. Y. (2019). Trazodone for the treatment of insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep medicine, 45, 25–32. https://doi.org/10.1016/j.sleep.2018.01.010

 
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User Interface Design: Unit 2 Individual Project

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User Interface Design: Unit 2 Individual Project

Table of Contents

Project Outline. 2

Project Site Description. 2

Project Purpose and Discussion Topics. 2

User Interface Technical Requirements. 3

Kiosk Requirements. 3

Smart Devise Requirements. 4

User Interface Human Interaction Requirements. 5

Kiosk Interaction Requirements. 6

Smart device Interaction Requirements. 6

User Interface Design Prototypes. 7

Kiosk Application. 7

Mobile Application. 9

Usability Test Questionnaire. 11

Usability Instruction Guide. 12

Usability Test Results. 13

 

Project Outline

Project Site Description

The project focuses on tourist attractions and things to do in Sedona, Arizona. Sedona is among the most beautiful tourist destinations in Arizona, with multiple activities to engage in and tourist attraction sites. The sceneries are stunning, and the views are outstanding across the whole region when walking, driving, or hiking. Sedona is often referred to as a spiritual center because of its energy vortexes. Tourists with different interests can have fun in the city because of its unique vibe. Multiple attractions are present, ranging from scenic natural areas and Native American ruins to galleries, sacred cities, and architecture. Tourists can engage in many activities in Sedona, including mountain biking, hiking, and stargazing, which are free.

For those who want to stay longer, which is worthwhile, there is adequate accommodation, with price ranges suitable for all classes of people. For those staying longer than a day, a trip to the Grand Canyon or Flagstaff is recommended. The most popular tourist attractions include cathedral rock, uptown Sedona, Red Rock Scenic Byway, Oak Creek Canyon scenic drive, hiking trails, jeep tours, Chapel of the Holy Cross, mountain biking trails, Vortexes, Bell Rock, Boynton Canyon, a day trip to the Grand Canyon, Slide Rock State Park, Palatki Ruins, Red Rock Crossing and Crescent Moon Picnic Site, Tlaquepaque Arts and Crafts Village, Amitabha Stupa and Peace Park, 1st Friday in the Art Galleries, and Airport Mesa.

Project Purpose and Discussion Topics 

In a place like Arizona, it would be convenient if tourists can find their way around without needing a tour guide or asking around too much. Therefore, web applications like the Tourist Kiosk application are designed to help tourists find their way around using either their computers, laptops, or smartphones. The application will include attractions and activities such as restaurants, shops, transportation, real estate, entertainment, services, and many others. The major discussion points in the project include user interface technical requirements and user interface human interaction requirements for both the kiosk and the smart device, user interface design prototypes, usability test questionnaire, usability instruction guide, and usability test results.

User Interface Technical Requirements

User Interface Design: Unit 2 Individual Project

Kiosk Requirements

The web application will be accessible through a computer, either a desktop or a laptop. The first prototype for the Tourist Kiosk will be developed per the following technical requirements. User insights are invited during the usability test of the prototype and additional requirements will be adopted in designing and developing the final product. Technical requirements for the kiosk include:

  • Operating System
    • Windows requirements: Windows 8 or later
    • Mac requirements: macOS High Sierra 10.13 or later
    • Linux requirements: 64-bit, Ubuntu 14.04+, Debian 8+, openSUSE 13.3+, or Fedora Linux 24+
  • Processor
    • Windows requirements: Intel Pentium 4 or later
    • Mac requirements: Intel
    • Linux requirements: Intel Pentium 4 or later
  • Memory: 2 GB minimum, 4 GB recommended
  • Screen Resolution: 1280×1024 or larger
  • Application window size: 1024×680 or larger
  • Internet connection: WIFI, LAN, modem, tethered.

(User Interface Design: Unit 2 Individual Project)

Smart Devise Requirements

The phone device will be available for Android devices and iPhones to ensure scalability. The requirements provided below are for the first prototype, which will be tested for usability, and in case of additional user requirements, like a call to expand specifications to cover more mobile devices, the specifications will be updated and integrated into the design of the final application. Technical requirements for smart devices include:

  • iOS and Phone requirements
    • iOS version >13
    • Phone hardware specifications: iPhone 6s onwards
  • Android OS and Phone Version
    • Android version >6.0.1
    • Phone hardware specifications:
      • ARM64, X86_64
      • Min 1GB RAM
      • Min Screen size: 5 inches
    • Provider web portal
      • Google Chrome (use latest version)
      • Firefox (use latest version)
      • Microsoft Edge (use latest version)
      • Minimum Resolution: 1024-pixel width

User Interface Human Interaction Requirements

Schneiderman’s eight golden rules of human interface interaction will guide the development of the Tourist kiosk. The design of the application will strive for consistency, consider universal usability, provide informative feedback, prevent errors, ensure action referrals, promote internal locus of control, and minimize short-term memory load. These rules will also be adopted during usability testing of the UI. The design seeks to ensure the application has simple task structures, visible controls, and correct mapping, is aesthetic and minimalistic, and promotes efficiency of use.

  • Regarding general interactivity for the kiosk and the smart device, the design will ensure consistency, provide meaningful feedback, require authentication, promote easy reversal of actions, minimize information that should be remembered, excuse mistakes, ensure context sensitivity, and utilize simple verbs and short phrases on controls.
  • The information displayed will be necessary and minimal to allow rapid navigation, labels and controls will be standard, colors probable, and visuals appropriate and not distractive. Tabs will be used to classify or categorize different information.
  • On data entry, the application will ensure fewer data input actions, steady information display and data input, and users can turn on their favorite input mode. Also, unsuitable demands per the context will be disabled and the user will be in control of the interaction. Help will be available for all input actions.

Kiosk Interaction Requirements

Developing the user interface for the tourist kiosk takes into perspective what the user values most when using an application or website and their perception of what the application should center on. Multiple principles guide the development of a user interface, especially ease of navigation, comfortable to use, and use of appropriate visuals and controls for the application to enhance user experience (Microsoft, 2022). The behavior and the UI of the application or site will be based on the what “feeling” the user gets from using the app. It will not be about how good-looking the application is but rather the great work it will perform in guiding tourists around Sedona. When designing the tourist kiosk user interface, these basic principles and guidelines will be adopted: spacing and positioning, size, grouping, and intuitiveness.

The design will ensure a professional-looking dialogue with proper spacing and appropriately placed controls. The labels will be aligned with the text baseline of the text boxes and other controls around them (Microsoft, 2022). Size consideration is fundamental when designing the UI. The design will ensure buttons are of perfect height and width, making it easy for users to notice them without fail. The third guideline is on grouping controls, and the design will employ intuitive grouping to make the controls easier to use. Tab controls will be used to group controls. Finally, the design will consider intuitiveness, which is imperative for a greater user experience. When designing tourist kiosk UI, color coding will be adopted to make navigation easier. It will enhance the recognition of texts using colors. The UI will contain easy-to-understand language and limited wording of controls.

Smart Device Interaction Requirements

The design of the smartphone or mobile user interface considers that tourists expect an almost perfect experience in their destination areas. To help tourists navigate Sedona with ease, the smartphone or mobile user interface will use well-known screens to help them feel comfortable when using the site or app. For instance, “Getting Started” and “Search Results” are among well-known screens that can be used (Baloh, 2023). The design will also ensure minimal clutter to enhance comprehension and eliminate anything unnecessary on the website or app. Gradual disclosures will be used, and additional information elements will be used. The design will also make interactive elements familiar and predictable for users. Because smartphone users depend solely on touch, the design will prioritize making controls accessible through familiarity and predictability. These design guidelines will enhance the tourist experience in Sedona.

User Interface Design Prototypes

The following prototypes represent the first design features of the kiosk and mobile applications:

Kiosk Application

For the Kiosk application, tourists are required to log in or sign up if they do not have an account. After signing in, users can engage with other pages and see some things to engage in in Sedona as tourists. There are categories, including attractions, activities, entertainment and family activities, arts and history, and fun activities, including sports, cycling, hiking, and drives. There is a category for people’s recommendations, which entails some images tourists can share on the website when reviewing it. To see what is under attractions, users will click on the attractions button to open up options. It is the case for the other categories. The buttons are links to options available for the specific category. For instance, if a tourist wants to see sporting activities, they will click the “Sports, cycling, hiking & drives” button or section. Each category is a link to its specific page with more details, including locations, maps, prices, and ratings of the various options. The information will make it easier for tourists to make their decisions on where to go based on their interests and budget. There is a category for the events calendar highlighting some events and dates specific to Sedona tourists might be interested in while there.

Mobile Application

The mobile application is a little different from the kiosk application, including its layout. The tourist will still be required to log in or sign up if they are using the application for the first time. After logging in, the tourist is taken to the “Things to Do” page with various categories of what to engage in while in Sedona. Categories include attractions and activities, restaurants and accommodations, entertainment and family, arts and history, sports, cycling, hiking, and drives. The user will have to click on a category to open a specific page for that category, which includes options and information specific to the options, including a map or location, prices, and ratings. Users can click on the “120 Posts” and similar buttons to view some of the images posted on the site.

(User Interface Design: Unit 2 Individual Project)

Usability Test Questionnaire

 

Usability Instruction Guide

 

Usability Test Results

 

 References

Baloh, I. (2023, April 7). Mobile App UI Design: An Expert’s Complete Guide for 2023. https://relevant.software/mobile-app-ui-design-guide/

Microsoft. (2022, September 02). User interface principles. https://learn.microsoft.com/en-us/windows/win32/appuistart/-user-interface-principles

 
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Controversy Associates with Dissociative Disorder 2

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Controversy Associates with Dissociative Disorder 2

Controversy Associates with Dissociative Disorder

Controversy Associates with Dissociative Disorder 

The controversy that surrounds dissociative disorders

Dissociation and dissociative disorders (DD) have been the subject of debate ever since the development of contemporary psychiatry and psychology. Even among professionals, dissociation/DD views are frequently not supported by the scientific literature. Multiple lines of research point to a strong connection between psychological trauma, particularly cumulative and/or early-life trauma, and dissociation/DD (Loewenstein, 2019). The argument presented by skeptics is that DDs are artifactual states caused by iatrogenic and/or sociocultural influences and that dissociation causes fantasies of trauma. Almost no clinical or research data lend weight to this assertion.

Dissociative identity disorder (DID) is the most common and controversial DD. The DID controversy is founded on the argument that the development of existing diagnostic measures renders first-person claims of dissociation based on those scales unreliable (Loewenstein, 2019). According to the argument, how these scales are made causes more false positives. The misinterpretation of other conditions, poor patient care, and insufficient treatment of depression have all been attributed to DID diagnoses (Loewenstein, 2019). Even when DID is treated with the best of intentions, psychotherapy may have unintended negative effects, and some patients report worsening symptoms and/or declining functionality. On whether DID is fake, some medical professionals question whether those who advocate the diagnosis of dissociative identity disorder have any financial or other conflicts of interest. An income of up to $20,000 per patient can be generated by the long-term, intensive psychotherapy care that people with DID typically get (Loewenstein, 2019). It gives doctors a strong incentive to identify DID.

(Controversy Associates with Dissociative Disorder 2)

My professional beliefs about dissociative disorders

Besides the controversy, I believe dissociative disorders are real and impact a significant part of the population. In most cases, the disease is misdiagnosed as schizophrenia due to the unjustified belief that the individual might be delusional (Mitra & Jain, 2021). Dissociative disorders are widespread in both general and clinical populations, and they constitute a significant underserved group with a high risk of self-harm and suicide (Pietkiewicz et al., 2021). Serious DD patients’ symptoms, including suicidal and self-destructive tendencies, significantly improved after treatment, according to prospective studies of treatment outcomes (Loewenstein, 2019). A significant public health initiative is required to promote understanding of dissociation/DD, including educational initiatives in all programs for mental health professionals and more financing for research.

Strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder

Building rapport and fostering trust in the therapeutic process are the main goals of the initial phase of treatment. The therapist tells the client that they will not be required to confront any topics that they do not feel comfortable facing and emphasizes that symptoms are a byproduct of identified factors during the assessment (Thayyil & Rani, 2020). The therapist empowers the client’s capacity for self-regulation and willingness to effect change within themselves while establishing a strong therapeutic alliance and retaining professional neutrality. The therapeutic relationship is reinforced by establishing and maintaining clear boundaries, developing reliable strategies to deal with emotions during therapy, establishing appropriate ways to assert oneself and deal with interpersonal conflict, acting mindfully, acknowledging changes, and appreciating the significance of the client’s efforts towards change and recovery.

Ethical and legal considerations related to dissociative disorders that should be brought to practice and why they are important

There are more than nine parts of lore and less than one part of the law in the entire legal situation pertaining to dissociation and pathological dissociation. In regards to all facets of the putative “special status” that dissociation phenomena, whether normal or sick in nature, purportedly deserve, there is a great deal more communal (and contradictory) tradition than statutory or judicial law (Kabene et al., 2022). The objective of the present examination is to determine if a person with DID is legally accountable for the offence they committed and whether they are capable of facing trial. There is no agreement within the legal system as to whether DID patients should be held accountable for their conduct, despite the fact that the disease is fundamentally defined by dissociative amnesia and that the host personality may only have minimal or no contact with the alters. Additionally, courts typically reject the accusations of insanity made by DID sufferers (Kabene et al., 2022). The excessive dependence on secondary data requires people to accept the inferences that have already been formed, and there is no chance to independently confirm those results, hence it is recommended that additional studies in the field integrate primary data into this study.

References

Kabene, S. M., Neftci, N. B., & Papatzikis, E. (2022). Dissociative Identity Disorder and the Law: Guilty or Not Guilty?. Frontiers in Psychology, 13.

Loewenstein R. J. (2019). Dissociation debates: everything you know is wrong. Dialogues in clinical neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2019.20.3/rloewenstein

Mitra, P., & Jain, A. (2021). Dissociative identity disorder. Statpearls [Internet].

Pietkiewicz, I. J., Bańbura-Nowak, A., Tomalski, R., & Boon, S. (2021). Revisiting false-positive and imitated dissociative identity disorder. Frontiers in psychology, 12, 637929.

Thayyil, M. M., & Rani, A. (2020). Structural Family Therapy with a Client Diagnosed with Dissociative Disorder. Indian Journal of Psychological Medicine, 43(6), 549-554.

 
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Bipolar Disorder and Conduct Disorder

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Bipolar Disorder and Conduct Disorder

Bipolar Disorder and Conduct Disorder SOAP Note

Bipolar Disorder and Conduct Disorder

Patient Initials: R.G.

Gender: Male

SUBJECTIVE:

CC: “I want to be left alone and be respected.”

HPI: The patient has a history of oppositional defiant disorder and mood dysregulation disorder and has now been admitted to the inpatient unit due to property destruction. Reportedly, the patient was getting his phone fixed, and he got into an argument with people at the mall. The police were called, and he was brought to the hospital. The patient has been irritable, threatening his parents, and does not follow rules at home. He has not been taking medication, but smoking marijuana. Patient was suspended from school after he was found with the possession of cannabis. He has a history of irritable mood, anger outbursts, physical and verbal aggression.  patient has no history of suicidal ideation or suicide attempt. No history of homicidal ideations or attempts.

Social History: R.G. lives with his parents. Patient has two other siblings.

Education and Occupation History: R.G. is in high school.

Substance Current Use and History: Recreational Drugs, Cannabis, Marijuana, 1 Daily

Legal History: The client denies any legal history, but he been punished in school by suspension.

Family Psychiatric/Substance Use History: Patient denies family mental health. Reports mother and father using alcohol occasionally.

Past Psychiatric History:

            Hospitalization: History of multiple hospitalizations at BNBMC.

Medication trials: Denies history of medical trials

Psychotherapy or Previous Psychiatric Diagnosis: Patient is historically noncompliant with medication after leaving hospital. History of physically aggressive behavior towards mother and sister with property destruction but a diagnosis was not established.

Medical History: None.

  • Current Medications: Denies using any medications currently.
  • Allergies:
  • Reproductive Hx: Sexually active. R.G. states using protection.

ROS:  

General: Patient is well-nourished, normal activity levels. Denies fever or fatigue.

HEENT: Eyes: Patient denies visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.

Skin: No rash or itching.

Cardiovascular: Denies chest pain, chest pressure, or chest discomfort. No palpitations or edema.

Respiratory: Denies wheezes, shortness of breath, consistent coughs, and breathing difficulties while resting.

Gastrointestinal: Patient denies diet changes, feelings of nausea and vomiting. Denies diarrhea. No abdominal pain or blood. Denies constipation. History of GERD.

Genitourinary: Denies burning on urination, urgency, hesitancy, odor, odd color

Neurological: The patient denies headaches, dizziness, syncope, paralysis, ataxia, numbness, or tingling in the extremities. No change in bowel or bladder control. Reports concentration and attention problems.

Musculoskeletal: The patient denies muscle pain and weakness. Denies back pain and muscle or joint stiffness. Moves all extremities well.

Psychiatric: History of behavior problems. Recent complaints of ill conduct.

Hematologic: Denies anemia, bleeding, or bruising.

Lymphatics: Denies enlarged nodes. No history of splenectomy.

Endocrinologic: Denies sweating. No reports of cold or heat intolerance. No polyuria or polydipsia.

OBJECTIVE:

Vital signs: Stable

Temp: 98.1F

B.P.: 128/62

P: 84

R.R.: 20

O2: 100% Room air

Pain: 0/10

Ht: 5’9 feet

Wt: 170 lbs

BMI: 25.1

BMI Range: Overweight

LABS:

Lab findings WNL

Tox screen: Positive

Alcohol: Positive

Physical Exam:

General appearance: The patient is awake, healthy-appearing, well-developed, and well-nourished.

HEENT: Normocephalic and atraumatic. Sclera anicteric, No conjunctival erythema, PERRLA, oropharynx red, moist mucous membranes.

Neck: Supple. No JVD. Trachea midline. No pain, swelling, or palpable nodules.

Heart/Peripheral Vascular: Regular rate and rhythm noted. No murmurs. No palpitation. No peripheral edema to palpation bilaterally.

Cardiovascular: The patient’s heartbeat and rhythm are normal. The patient’s heart rate is within normal range, and capillaries refill within two seconds.

Musculoskeletal: Normal range of motion. Normal motor strength and tone.

Respiratory: No wheezes, and respirations are easy and regular.

Neurological: Balance is stable, gait is normal, posture is erect, the tone is good, and speech is clear. The patient has occasional headaches.

Psychiatric: The patient is easily distracted and is irritable and uncooperative in some instances.

Neuropsychological testing: Social-emotional functioning is impaired.

Behavior/motor activity: Patient was easily irritable and uncooperative in some instances.

Gait/station: Stable.

Mood: Fair.

Affect: Fair.

Thought process/associations: comparatively linear and goal-directed.

Thought content: Thought content was appropriate.

Attitude: the patient was irritable and uncooperative at times

Orientation: Oriented to self, place, situation, and general timeframe.

Attention/concentration: Impaired

Insight: Good

Judgment: Good.

Remote memory: Good

Short-term memory: Good

Intellectual /cognitive function: Good

Language: clear speech, with a tone assessed to be normal

Fund of knowledge: Good.

Suicidal ideation: Negative.

Homicide ideation: Negative.

ASSESSMENT:

Mental Status Examination:

The male patient, 17, complains of wanting be left alone and respected. The patient presents with ill and uncontrollable behavior and conduct. The patient is combative, bullying, uncooperative, and easily agitated and angered. Building rapport was difficult because the patient had trouble focusing and paying attention. His mood and affect were fair, but he was apathetic, had difficulty concentrating, and was quickly disoriented. He denies having any suicidal or homicidal ideas.

Differential Diagnosis:

  1. 9 Conduct Disorder and F31.1 Bipolar I Disorder (Confirmed)

Bipolar disorder, commonly referred to as bipolar affective disorder, ranks as one of the top 10 major causes of disability worldwide. It is common to first misdiagnose bipolar disorder, which is characterized by recurrent periods of mania or hypomania that alternate with depression (Jain & Mitra, 2022). Bipolar and related disorders include undefined bipolar or related disorders, bipolar I disorder (BD-I), bipolar II disorder (BD-II), cyclothymic disorder, and other specified bipolar and related illnesses. Per the DSM-5 diagnosis, for a patient to be diagnosed with bipolar I disorder, criteria should meet for at least one manic episode, which could have been preceded or followed by a significant depression or hypomanic episode, although major depressive or hypomanic episodes are not necessary for the diagnosis (Jain & Mitra, 2022). In clinical, epidemiological, and research samples, a strong and bidirectional connection between pediatric bipolar I (BP-I) disorder and conduct disorder (CD) has continuously been found (Wozniak et al., 2019). Even though BP-I and CD are two separate, highly morbid illnesses, their co-occurrence signals a gravely compromised clinical condition.

Disruptive behavioral disorders include conduct disorder (CD) and oppositional defiant disorder (ODD). In some circumstances, ODD appears before CD. CD is characterized by a series of behaviors that include showing hostility and violating other people’s rights. Conduct disorder frequently co-occurs with other psychiatric diseases, such as depression, attention deficit hyperactivity disorder, and learning problems (Mohan et al., 2023). It is vital to remember that occasional rebellious conduct and a propensity to disrespect and disobey authority figures can be seen frequently during childhood and adolescence. The signs and symptoms of CD show a pervasive and recurrent pattern of hostility towards people and animals, as well as the destruction of property and breaking of regulations (Sagar et al., 2019). Per the DMS-5 criteria, an individual has to exhibit behaviors that include violation of other people’s rights and disregard acceptable conduct. The individuals should demonstrate dysfunction in various areas, including aggression toward other people and animals such as initiating fights, carrying and using weapons, bullying, threatening, and being cruel towards people and animals, deliberate property destruction, stealing and lying, and significant violation of rules like running away from home and staying out late (Zhang et al., 2018). R.G. presents with all these dysfunctions, confirming the diagnoses.

  1. 3 Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is another disruptive behavioral condition that frequently precedes CD. ODD is infrequently recognized in older children and teenagers, owing partially to the continuously established disagreements between children and their parents. Males are more prevalent than girls to have ODD in preadolescence (1.4:1), however, this male predominance does not exist in adolescents or adults (Aggarwal & Marwaha, 2022). Symptoms are thought to be steady around the ages of five and 10, after which they begin to decline. The prevalence reduces as people age. It primarily involves problems with emotional and behavioral inhibition. A recurrent pattern of anger or irritation, argumentative or rebellious behavior, or revenge towards other people is the primary hallmark of ODD, per the DSM-5 criteria (Aggarwal & Marwaha, 2022). Because the patient also displayed additional symptoms that met CD criteria alongside the ODD symptoms, this diagnosis was ruled out.

  1. 9. Attention Deficit Hyperactivity Disorder

ADHD co-occurs frequently with CD, hampering an individual’s capacity to function. People who suffer from this condition have excessive degrees of impulsivity, hyperactivity, or inattentiveness. According to Magnus et al. (2023), young children with ADHD frequently display inattentiveness, lack of attention, disorganization, difficulties finishing tasks, forgetfulness, and losing things. For symptoms to be considered ADHD, they must appear before the age of 12, last for six months, and interfere with daily tasks. It must be present in numerous settings, such as at home and work or in both after-school programs and classes (Magnus et al., 2023). Large-scale effects could lead to challenging social relations, an increase in risky behavior, job losses, and challenges in the classroom. Because ADHD was not recognized before the age of 12 and because the client only exhibits inattentiveness and no functioning challenges, the diagnosis was rejected.

PLAN:

The patient would benefit from combining medication and psychotherapy.

Safety Risk/Plan:

R.G. has no present objective or desire to hurt himself or others. There are no suicidal or homicidal ideas in the patient. It is not essential to register.

Pharmacological Interventions:

Pharmacotherapy tries to treat mental co-morbidities using the appropriate medications, such as stimulants and non-stimulants for the treatment of ADHD, antiepileptic drugs for the treatment of bipolar illness, and mood stabilizers for the treatment of aggression and mood dysregulation (Mohan et al., 2023). Traditional mood stabilizers that can elevate mood include second-generation antipsychotics and antiepileptic drugs (AEDs). Proposal medication plan includes Depakote 250 in AM, 500 at bedtime, (delay release) Risperidone 1 mg bid and Cogentin 0.5 once a day.

Psychotherapy:

The psychosocial treatment that can help address conduct disorder in R.G. includes parent management training, which teaches parents ways to discipline their children consistently, reward positive behavior properly, and promote prosocial behavior in young people, multisystemic therapy, which focuses on family, school, and individual issues, and anger management training. Additionally, individual psychotherapy that emphasizes problem-solving skills helps treat CD by fostering connections through resolving interpersonal conflicts and by teaching assertiveness to reject negative communal influences (Mohan et al., 2023). Community-based treatment will be centered on creating therapeutic school settings that can provide a structured program to reduce disruptive behaviors in the future.

Education:

  1. Educate parent and patient on drug adherence, potential adverse effects, and complications from taking the medication.
  2. Educate the patient regarding consistent therapy sessions and why they are necessary.
  3. To prevent relapse, monitor withdrawal symptoms frequently.
  4. Inform the client regarding healthy behaviors and attitudes.
  5. Encourage the patient to cooperate with the medical staff and to seek assistance at any time.
  6. Encourage the client to take part in group therapy or a support group to develop social skills.

Consultation/follow-up: Follow-up is in two weeks for further assessment.

Reflection

Children with bipolar disorder are more likely to experience conduct issues. Children and adolescents who have conduct disorders are prevalent, and these disorders are frequently linked to developmental stages and traits. Adolescence is a time when occasional disobedience and bad behavior is normal or anticipated. When there is a reoccurring pattern and behavioral dysfunctions are present, the situation becomes problematic. In some cases, such as this one, parents and instructors are unable to effectively handle conduct dysfunctions and must seek professional assistance. Since the patient is seen as problematic and may become aggressive toward the practitioner, dealing with CD presents difficulties for practitioners as well. But when professionals, parents, and instructors collaborate, the process is more successful.

At some point in their lives, over half of all Americans will receive a mental condition diagnosis. Healthy People 2030 emphasizes the prevention, screening, evaluation, and treatment of behavioral and mental problems (Healthy People 2030, n.d.). The goals for mental health and mental disorders also include improving the health and standard of living for those who suffer from these problems. Health promotion techniques for conduct disorder can assist reinforce responsible conduct by providing consistent adult caregiving, positive emotional support, proper learning and social skills, an easy temperament, a sense of competence, and optimistic worldviews. Autonomy and confidentiality are ethical issues that arise when working with the client, given he is a minor. Any sort of treatment should only be given with the parent’s informed consent. If I were given another chance to work with the client, I would ask the instructor and the school’s disciplinary staff for information so that I could create a more thorough diagnosis and treatment plan.

 

References

Healthy People 2030. (n.d.). Mental Health and Mental Disorders. https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders

Jain, A., & Mitra, P. (2022). Bipolar affective disorder. In StatPearls [Internet]. StatPearls Publishing.

Mohan, L., Yilanli, M., & Ray, S. (2017). Conduct disorder. In: StatPearls [Internet]. StatPearls Publishing.

Aggarwal, A., & Marwaha, R. (2022). Oppositional Defiant Disorder. In StatPearls [Internet]. StatPearls Publishing.

Magnus, W., Nazir, S., & Anilkumar, A.C. (2023). Attention Deficit Hyperactivity Disorder. In: StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441838/

Sagar, R., Patra, B. N., & Patil, V. (2019). Clinical Practice Guidelines for the management of conduct disorder. Indian journal of psychiatry, 61(Suppl 2), 270–276. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_539_18

Wozniak, J., Wilens, T., DiSalvo, M., Farrell, A., Wolenski, R., Faraone, S. V., & Biederman, J. (2019). Comorbidity of bipolar I disorder and conduct disorder: a familial risk analysis. Acta psychiatrica Scandinavica, 139(4), 361–368. https://doi.org/10.1111/acps.13013

Zhang, J., Liu, W., Zhang, J., Wu, Q., Gao, Y., Jiang, Y., Gao, J., Yao, S., & Huang, B. (2018). Distinguishing Adolescents With Conduct Disorder From Typically Developing Youngsters Based on Pattern Classification of Brain Structural MRI. Frontiers in human neuroscience, 12, 152. https://doi.org/10.3389/fnhum.2018.00152

 
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Controversy Associates with Dissociative Disorder

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Controversy Associates with Dissociative Disorder

Controversy Associates with Dissociative Disorder

Controversy Associates with Dissociative Disorder

The controversy that surrounds dissociative disorders

Dissociative disorders (DD) have been the subject of debate ever since the development of contemporary psychiatry and psychology. Even among professionals, DD views are frequently not supported by the scientific literature. Multiple lines of research point to a strong connection between psychological trauma, particularly cumulative and early-life trauma, and DD (Loewenstein, 2019). The argument presented by skeptics is that DDs are artifactual states caused by iatrogenic or sociocultural influences and dissociation causes trauma fantasies. However, almost no clinical or research data lend weight to this assertion.

Dissociative identity disorder (DID) is the most common and controversial DD. It is founded on the argument that the development of existing diagnostic measures renders first-person claims of dissociation based on those scales unreliable (Loewenstein, 2019). According to the argument, how these scales are made causes more false positives. The misinterpretation of other conditions, poor patient care, and insufficient treatment of depression have all been attributed to DID diagnoses (Loewenstein, 2019). Even when DID is treated with the best of intentions, psychotherapy may have unintended negative effects, and some patients report worsening symptoms and declining functionality. On understanding if DID is fake, some medical professionals question whether those who advocate the diagnosis of dissociative identity disorder have any financial or other conflicts of interest. According to Loewenstein (2019), physicians or organizations can generate an income of up to $20,000 per patient from the long-term intensive psychotherapy care that people with DID typically get, giving doctors a strong incentive to identify DID. It implies that doctors can continue to wrongfully diagnose people with DID because its treatment is a significant revenue stream.

My professional beliefs about dissociative disorders

Besides the controversy, I believe dissociative disorders are real and impact a significant part of the population. In most cases, the disease is misdiagnosed as schizophrenia due to the unjustified belief that the individual might be delusional (Mitra & Jain, 2021). Dissociative disorders are widespread in both general and clinical populations, and they constitute a significant underserved group with a high risk of self-harm and suicide (Pietkiewicz et al., 2021). Serious DD patients’ symptoms, including suicidal and self-destructive tendencies, significantly improved after treatment, according to prospective studies of treatment outcomes (Loewenstein, 2019). A significant public health initiative is required to promote understanding of dissociation/DD, including educational initiatives in all programs for mental health professionals and more financing for research.

(Controversy Associates with Dissociative Disorder)

Strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder

Building rapport and fostering trust in the therapeutic process are the main goals of the initial phase of treatment. The therapist tells the client that they will not be required to confront any topics that they do not feel comfortable facing and emphasizes that symptoms are a byproduct of identified factors during the assessment (Thayyil & Rani, 2020). The therapist empowers the client’s capacity for self-regulation and willingness to effect change within themselves while establishing a strong therapeutic alliance and retaining professional neutrality. The therapeutic relationship is reinforced by establishing and maintaining clear boundaries, developing reliable strategies to deal with emotions during therapy, establishing appropriate ways to assert oneself and deal with interpersonal conflict, acting mindfully, acknowledging changes, and appreciating the significance of the client’s efforts towards change and recovery.

Ethical and legal considerations related to dissociative disorders that should be brought to practice and why they are important

There are more than nine parts of lore and less than one part of the law in the entire legal situation pertaining to dissociation and pathological dissociation. In regards to all facets of the putative “special status” that dissociation phenomena, whether normal or sick in nature, purportedly deserve, there is a great deal more communal (and contradictory) tradition than statutory or judicial law (Kabene et al., 2022). The objective of the present examination is to determine if a person with DID is legally accountable for the offence they committed and whether they are capable of facing trial. There is no agreement within the legal system as to whether DID patients should be held accountable for their conduct, despite the fact that the disease is fundamentally defined by dissociative amnesia and that the host personality may only have minimal or no contact with the alters. Additionally, courts typically reject the accusations of insanity made by DID sufferers (Kabene et al., 2022). The excessive dependence on secondary data requires people to accept the inferences that have already been formed, and there is no chance to independently confirm those results, hence it is recommended that additional studies in the field integrate primary data into this study.

References

Kabene, S. M., Neftci, N. B., & Papatzikis, E. (2022). Dissociative Identity Disorder and the Law: Guilty or Not Guilty?. Frontiers in Psychology, 13.

Loewenstein R. J. (2019). Dissociation debates: everything you know is wrong. Dialogues in clinical neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2019.20.3/rloewenstein

Mitra, P., & Jain, A. (2021). Dissociative identity disorder. Statpearls [Internet].

Pietkiewicz, I. J., Bańbura-Nowak, A., Tomalski, R., & Boon, S. (2021). Revisiting false-positive and imitated dissociative identity disorder. Frontiers in psychology, 12, 637929.

Thayyil, M. M., & Rani, A. (2020). Structural Family Therapy with a Client Diagnosed with Dissociative Disorder. Indian Journal of Psychological Medicine, 43(6), 549-554.

 
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Assignment 1 – Professional Presentation

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Assignment 1 – Professional Presentation

 Student’s Name:

Institution of Affiliation:

Course Code + Course Title

Instructor’s Name:

Assignment Due Date:

Assignment 1 - Professional Presentation

Assignment 1

Professional presentation allows sharing of ideas and research findings with a specific audience. It is imperative to deliver the message clearly and concisely. These presentations contribute to the evidence base the evaluation team will utilize to provide feedback regarding the presentation and the subject matter. Professional presentation skills are critical in nursing because they help students pass information and convince stakeholders to engage in positive changes that impact the organization and patients in the facility. A personal strength regarding professional presentation would be delivering well-organized and researched work. I take time researching a particular topic to ensure I understand the concepts well and find appropriate evidence base to go along and make the work more compelling. I also organize my presentation well to ease readability and flow and make it easier to deliver the right message clearly. Proper organization and robust research on the topic build my confidence before a presentation because I feel I am well-prepared for any form of evaluation or question (University of Minnesota, 2023). Although it is a strength, I can still improve by establishing a purpose and identifying the main ideas, organizing them in an outline, researching them, developing a presentation, and rehearsing it, before delivering it to the audience.

(Assignment 1 – Professional Presentation)

I am always anxious before a presentation, which impacts my confidence and thought organization. Being organized and conducting robust research is a method of minimizing anxiety before a presentation, but mostly, I cannot help it. It eases after beginning to present, but I need to minimize anxiety right before a presentation. Methods I can adopt to be calmer before a professional presentation would be recognizing that I am anxious and it is typical before a major presentation, observing my instincts, and trying to be comfortable that anxiety is part of the process (Su, 2019). Something positive is that confidence builds during presentations because I have prepared my work well. I should accept that anxiety before it is normal and be comfortable with it.

References

Su, J. A. (2019). How to Calm Your Nerves Before a Big Presentation. Harvard Business Review. https://hbr.org/2016/10/how-to-calm-your-nerves-before-a-big-presentation

University of Minnesota. (2023). 14.1 Organizing a Visual Presentation. Libraries. https://open.lib.umn.edu/writingforsuccess/chapter/14-1-organizing-a-visual-presentation/

 
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